04 NCAC 10C .0106          PROFESSIONAL RESPONSIBILITY OF THE REHABILITATION PROFESSIONAL IN WORKERS' COMPENSATION CLAIMS

(a)  The RP shall exercise independent professional judgment in making and documenting recommendations for medical and vocational rehabilitation for the injured worker, including any alternatives for medical treatment and cost-effective return-to-work options including retraining or retirement. The RP shall realize that the attending physician directs the medical care of an injured worker.

(b)  The RP shall inform the parties of his or her assignment and proposed role in the case.  At the outset of the case, the RP shall disclose to health care providers and the parties any possible conflict of interest, including. any compensation carrier's or employer's ownership of or affiliation with the RP. 

(c)  Subject to the provisions for medical care and treatment set forth in the Workers' Compensation Act, the medical RP may explain the medical information to the worker, and shall discuss with the worker all treatment options appropriate to the worker's conditions, but shall not advocate any one specific source for treatment or change in treatment.

(d)  As case consultants or expert witnesses, RPs have an obligation to provide unbiased, objective opinions.  The limits of their relationships shall be clearly defined through written or oral means in accordance with CRCC Code of Professional Ethics, Canon 2, Rule 2.4, or through similar provisions in the applicable code of ethics, if any.

(e)  There may be parts of the rehabilitation process for which an RP may not be qualified.  The RP has the responsibility to refrain from those activities which do not fall within his or her qualifications.  RPs shall practice only within the boundaries of their competence, based on their education, training, appropriate professional experience, and other professional credentials.

(e)  Prohibited Conduct:

(1)           RPs shall not conduct or assist any party in claims negotiation, investigative activities, or perform any other non-rehabilitation activity;

(2)           RPs shall not advise the worker as to any legal matter including claims settlement options or procedures, monetary evaluation of claims, or the applicability to the worker of benefits of any kind under the Workers' Compensation Act.  RPs shall advise the nonrepresented worker to direct such questions to the Industrial Commission, and the represented worker to direct questions to his or her attorney.

(3)           RPs shall not accept any compensation or reward from any source as a result of settlement.

History Note:        Authority G.S. 97-25.4;

Eff. January 1, 1996;

Amended Eff. June 1, 2000.